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Preauthorization Associate in Jamesburg, NJ at Accounting Now

Date Posted: 6/15/2020

Job Snapshot

  • Employee Type:
  • Location:
    Jamesburg, NJ
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
  • Job ID:

Job Description

PREAUTHORIZATION ASSOCIATE NEEDED FOR wonderful medical office in Monroe Township, NJ.

  • To obtain imaging precertification requests and process while providing excellent customer service.
  • Must be able to review structured clinical data and follow established compliance procedures.
  • Must also be able to communicate effectively with internal and external contacts


  • Answer calls/requests from physician offices, providers, insurance companies, and patients using exemplary customer service skills.
  • Follow the appropriate procedure when an authorization request is received
  • Verification of insurance eligibility
  • Create/update patient accounts with accurate demographic and appointment information.
  • Maintain patient confidentiality and patient privacy standards.
  • Determine authorization requirements based in specific insurance carrier rules.
  • Review and obtain patient clinical information from providers or previous medical history.
  • Initiate and follow through on the authorization process. Submit requested clinical information to insurance carriers during the review process if needed.
  • Approval information to be enterd into the appropriate electronic databases.
  • The appointment information is updated with accurate authorization details and forwarded to the respective referring physician.
  • Contact the patient to schedule the appointment and provide any relevant instructions or preparations for the specific study.
  • Follow the appropriate procedure when an authorization request is denied.
  • Effectively communicate the denial information to the referring physician and/or patient.
  • Contact insurance carrier to discuss review options such as appeal, reconsideration, or peer to peer review.
  • Peer to peer reviews will be set up based on referring physician schedule.
  • Follow through until the review process is complete.
  • Effectively communicate review decision with referring physician and/or patient.
  • Manage day to day responsibilities
  • Periodic review of daily schedule for add-on and emergent, same day studies.
  • Monitoring of incoming fax and email requests.
  • Effectively communicate with the Director of Operations and Monroe Clinical Operations Manager
  • Provide periodic updates to the Director of Operations
  • Communicate any customer experience issues or concerns to management.

  • Qualifications:

    • Previous experience in a team lead or management position.
    • Previous experience in insurance verification/preauthorization
    • Strong knowledge in clinical data and medical terminology.
    • Ability to work effectively in an independent environment.
    • Detail oriented with strong organizational skills.
    • Self motivated with a desire to provide excellent customer service.